Swedish Covenant Hospital

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Swedish Covenant Hospital

2012 Community Health Needs Assessment

In the spring of 2012, Swedish Covenant Hospital (SCH) embarked on a comprehensive Community

Health Needs Assessment (CHNA) process to identify and address the key health issues for our

community.

Swedish Covenant Hospital is a comprehensive health care facility providing health and wellness services to

Chicago’s North and Northwest side communities. This 323-bed hospital is one of the few independent, nonprofit

hospitals in the area. Its 600 physicians and 2,200 employees remain focused on the hospital’s mission of providing

compassionate, high quality care in a healing environment. An established teaching hospital, Swedish Covenant

Hospital offers a range of medical programs, including the latest cardiac, cancer, orthopedic, surgical, women’s

health, back health and emergency services.

Swedish Covenant Hospital (SCH) maintains a department dedicated to addressing its outreach objectives of serving

the entire community, not only those who come through its doors. Building on a long tradition of service, the

Community Relations Department utilizes hospital strengths alongside those of other well-established community

partners. This strategy allows SCH to better understand and reach the most vulnerable sectors of the community,

while meeting pressing healthcare needs. The goal is to improve the community’s health status by empowering

citizens to make healthy lifestyle choices.

Definition of the Community Served [IRS Form 990, Schedule H, Part V, Section B, 1a, 2]

Swedish Covenant Hospital completed its last Community Health Needs Assessment in

2009.

CHNA Community Definition

SCH’s community, as defined for the purposes of the Community Health Needs

Assessment, included each of the residential ZIP Codes that comprise the hospital’s

Primary Service Area (PSA) and Secondary Service Area (SSA), including: 60613, 60618,

60625, 60626, 60630, 60640, 60641, 60645, 60646, 60659, 60660 and 60712. A

geographic description is illustrated in the following map.

This community definition was determined because the majority of SCH’s patients

originate from this area.

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Demographics of the Community [IRS Form 990, Schedule H, Part V, Section B, 1b]

The population of the hospital’s service area is estimated at 631,311 people. It is

predominantly non-Hispanic White (63.66%), but also has substantial Hispanic (28.75%)

and Asian (10.87%) populations.

As throughout the state and nation, our population is aging, with 10.94% currently age

65 and older. This is projected to increase in coming years, as is the need for services

to meet the health needs of this older population.

Median household income is below the state average at $48,386, and 12.37% of the

families in our population remain below the poverty level.

US Census QuickFacts

SCH

Service

Area (c)

Cook

County Illinois

Population, 2012 estimate 631,311 5,231,351 12,875,255

Population, 2010 626,806 5,194,675 12,830,632

Persons under 5 years, percent, 2011 6.7% 6.6% 6.4%

Persons under 18 years, percent, 2011 20.65% 23.5% 24.1%

Persons 65 years and over, percent, 2011 10.94% 12.1% 12.7%

Female persons, percent, 2011 49.87% 51.5% 50.9%

White persons, percent, 2011 (a) 63.66% 66.0% 78.0%

Black persons, percent, 2011 (a) 8.58% 25.0% 14.8%

American Indian and Alaska Native persons, percent, 2011 (a)

0.6% 0.8% 0.6%

Asian persons, percent, 2011 (a) 10.9% 6.5% 4.8%

Native Hawaiian and Other Pacific Islander persons, percent, 2011 (a)

.05% 0.1% 0.1%

Persons reporting two or more races, percent, 2011 3.63% 1.7% 1.7%

Persons of Hispanic or Latino Origin, percent, 2011 (b) 28.75% 24.4% 16.2%

White persons not Hispanic, percent, 2011 50.07% (d) 43.7% 63.3%

Living in same house 1 year & over, percent, 2007-2011 NA 86.3% 86.7%

Foreign born persons, percent, 2007-2011 NA 21.0% 13.7%

Language other than English spoken at home, percent age 5+, 2007-2011

47.4% 34.0% 22.0%

High school graduate or higher, percent of persons age 25+, 2007-2011

83.9% 83.7% 86.6%

Bachelor's degree or higher, percent of persons age 25+, 2007-2011

40.96% 33.7% 30.7%

Veterans, 2007-2011 NA 232,373 770,388

Mean travel time to work (minutes), workers age 16+, 2007-2011

37.6 31.8 28.1

Housing units, 2011 289,827 (d) 2,175,941 5,297,318

Homeownership rate, 2007-2011 43.5% (d) 59.8% 68.7%

Housing units in multi-unit structures, percent, 2007-2011 77.4% (d) 53.9% 32.9%

Median value of owner-occupied housing units, 2007-2011 $258,085 $256,900 $198,500

Households, 2007-2011 262,998 1,934,771 4,773,002

Persons per household, 2007-2011 2.35 2.64 2.62

Per capita money income in the past 12 months (2011 dollars), 2007-2011 NA $29,920 $29,376

Median household income, 2007-2011 $48,386 $54,598 $56,576

Persons below poverty level, percent, 2007-2011 12.37% 15.8% 13.1% (a) Includes persons reporting only one race.

(b) Hispanics may be of any race, so also are included in applicable race categories.

(c) SCH Service Area statistics are all based on 2013 estimates, except for row Population, 2010, which is based on 2010 Census Data.

(d) Based on 2013 Population Estimates provided by Nielsen.

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Existing Healthcare Facilities & Resources [IRS Form 990, Schedule H, Part V, Section B, 1c]

Swedish Covenant Hospital recognizes that there are many existing healthcare facilities

and resources within the community that are available to respond to the health needs

of residents. These organizations include the following:

Acute-Care Hospitals/Emergency Rooms

North Shore University Health Systems

St. Francis Hospital

Illinois Masonic Hospital

Our Lady of Resurrection Health Care

Lutheran General Hospital

St. Joseph Hospital

Lurie Children’s Hospital

Northwestern Memorial Hospital

Thorek Memorial Hospital

Weiss Memorial Hospital

Federally Qualified Health Centers & Other Safety Net Providers

Erie Family Health Centers (FQHC)

Heartland Health Centers (FQHC)

Asian Human Services (FQHC)

Access Health Services (FQHC)

Nursing Homes/Adult Care

Covenant Home

Bradley Place

The Hartwell

Harmony Health Care & Rehabilitation

Ambassador Nursing Home

Continental Nursing Home

Peterson Park Nursing Home

Lincolnwood Place

Alden Health Care & Senior Living

Mental Health Services/Facilities

Erie Family Health Centers(FQHC)

North River Mental Health Center

Community Counseling Centers of Chicago (C4)

Emergency Medical Services (EMS)

City of Chicago EMS Division

Lincolnwood Fire Department

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Home Healthcare

NorthShore University System Home Health Care

Presence/Resurrection Home Health Care

Home Health of Illinois

All About HHC

Apple

Med Life

Hospice Care

Rainbow Hospice

Horizon Hospice & Palliative Care

Midwest Palliative & Hospice CareCenter

School Health Services

Heartland Health Centers (Roosevelt High School and Hibbard Elementary)

Erie Family Health Center (Amundsen High School)

Other Community-Based Resources

Community Counseling Centers of Chicago (C4)

Albany Park Community Center

Korean American Community Services

Centro Romero

Polish Initiative of Chicago

World Relief Chicago

Cambodian Association

Hanul Family Alliance

Jane Addams Resource Corporation

Hamdard Center for Health and Human Services

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How CHNA Data Were Obtained [IRS Form 990, Schedule H, Part V, Section B, 1d]

Collaboration [IRS Form 990, Schedule H, Part V, Section B, 4]

The Community Health Needs Assessment was sponsored by the Swedish Covenant

Hospital Foundation, in cooperation with the Metropolitan Chicago Healthcare Council

(MCHC). The project also received input from several Community Health Needs

Assessment Focus Groups, which were comprised of representatives of the partnering

organizations as well as other citizens chosen for their relevant experience and

interests.

CHNA Goals & Objectives

This Community Health Needs Assessment, a follow-up to a similar study conducted in

2009, is a systematic, data-driven approach to determining the health status, behaviors

and needs of residents in the service area of Swedish Covenant Hospital. Subsequently,

this information will be used to inform decisions and guide efforts to improve

community health and wellness.

The Community Health Needs Assessment provides the information so that

communities may identify issues of greatest concern and decide to commit resources

to those areas, thereby making the greatest possible impact on community health

status. The 2012 PRC Community Health Needs Assessment serves as a tool toward

reaching three basic goals:

To improve residents’ health status, increase their life spans, and elevate

their overall quality of life. A healthy community is not only one where its

residents suffer little from physical and mental illness, but also one where its

residents enjoy a high quality of life.

To reduce the health disparities among residents. By gathering

demographic information along with health status and behavior data, it will be

possible to identify population segments that are most at-risk for various

diseases and injuries. Intervention plans targeting these individuals may then

be developed to combat some of the socio-economic factors which have

historically had a negative impact on residents’ health.

To increase the accessibility of preventive services for all community

residents. More accessible preventive services will prove beneficial in

accomplishing the first goal (improving health status, increasing life spans, and

elevating the quality of life), as well as lowering the costs associated with caring

for late-stage diseases resulting from a lack of preventive care.

This assessment was conducted by Professional Research Consultants, Inc. (PRC). PRC

is a nationally-recognized healthcare consulting firm with extensive experience

conducting Community Health Needs Assessments such as this in hundreds of

communities across the United States since 1994.

CHNA Methodology

This assessment incorporates data from both quantitative and qualitative sources.

Quantitative data input includes primary research (the PRC Community Health Survey)

and secondary research (vital statistics and other existing health-related data); these

quantitative components allow for comparison to benchmark data at the state and

national levels.

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Qualitative data input includes primary research gathered through a series of Key

Informant Focus Groups.

Community Health Survey

The survey instrument used for this study is based largely on the Centers for Disease

Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), as

well as various other public health surveys and customized questions addressing gaps

in indicator data relative to health promotion and disease prevention objectives and

other recognized health issues. The final survey instrument was developed by PRC, with

input from SCH and the other community sponsors.

A precise and carefully executed methodology is critical in asserting the validity of the

results gathered in the PRC Community Health Survey. Thus, to ensure the best

representation of the population surveyed, a telephone interview methodology — one

that incorporates both landline and cell phone interviews — was employed. The

primary advantages of telephone interviewing are timeliness, efficiency and random-

selection capabilities.

The sample design used for this effort consisted of a random sample of 515 individuals

age 18 and older in the Swedish Covenant Hospital Service Area. Once the interviews

were completed, these were weighted in proportion to the actual population

distribution so as to appropriately represent the Swedish Covenant Hospital Service

Area as a whole. All administration of the surveys, data collection and data analysis was

conducted by Professional Research Consultants, Inc. (PRC). For statistical purposes, the

maximum rate of error associated with a sample size of 515 respondents is ±4.4% at

the 95 percent level of confidence.

The sample design and the quality control procedures used in the data collection

ensure that the sample is representative. Thus, the findings may be generalized to the

total population of community members in the defined area with a high degree of

confidence.

Public Health, Vital Statistics & Other Data

A variety of existing (secondary) data sources was consulted to complement the

research quality of this Community Health Needs Assessment. Data for the Swedish

Covenant Hospital Service Area were obtained from the following sources (specific

citations are included with the graphs throughout this report):

Centers for Disease Control & Prevention

Illinois Department of Public Health

Illinois State Police

National Center for Health Statistics

US Census Bureau

US Department of Health and Human Services

US Department of Justice, Federal Bureau of Investigation

Note that secondary data reflect city-level data (City of Chicago) where possible, and

county-level data (Cook County) where city data are unavailable.

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Community Stakeholder Input [IRS Form 990, Schedule H, Part V, Section B, 1h & 3]

As part of the Community Health Needs Assessment, seven focus groups were held

among key informants in the community on June 21-22 and July 11-12, 2012, each

focusing on needs within different geographies or among certain populations.

These key informant focus groups allowed for input from persons with special

knowledge of or expertise in public health, as well as others who represent the interests

of key cultural groups represented in communities served by Swedish Covenant

Hospital. In all, 50 key informants participated, including physicians, other health

professionals, social service providers, business leaders, minority organizations and

other community leaders.

Potential participants were chosen because of their ability to identify primary concerns

of the populations with whom they work, as well as of the community overall.

Participants included a representative of public health, as well as several individuals

who work with low-income, minority or other medically underserved populations, and

those who work with persons with chronic disease conditions. Specific names/titles of

those participating are available upon request.

Participant Type Date Geographic Focus

Community Leaders June 21, 2012 Cook County

Community Leaders June 22, 2012 North Chicago

Community Leaders July 11, 2012 SCH Service Area

Key Informants Serving Polish Population July 11, 2012 SCH Service Area

Key Informants Serving Hispanic Population July 11, 2012 SCH Service Area

Key Informants Serving Asian Indian Population July 12, 2012 SCH Service Area

Representatives of Swedish Covenant Hospital July 12, 2012 SCH Service Area

Information Gaps [IRS Form 990, Schedule H, Part V, Section B, 1i]

While this Community Health Needs Assessment is quite comprehensive, SCH and PRC

recognize that it cannot measure all possible aspects of health in the community, nor

can it adequately represent all possible populations of interest. It must be recognized

that these information gaps might in some ways limit the ability to assess all of the

community’s health needs.

For example, certain population groups — such as persons who are homeless,

institutionalized, or who only speak a language other than English or Spanish — are not

represented in the survey data. Other population groups — for example, pregnant

women, lesbian/gay/bisexual/transgender residents, undocumented residents, and

members of certain racial/ethnic or immigrant groups — might not be identifiable or

might not be represented in numbers sufficient for independent analyses.

In terms of content, this assessment was designed to provide a comprehensive and

broad picture of the health of the overall community. However, there are certainly a

great number of medical conditions that are not specifically addressed.

Vulnerable Populations [IRS Form 990, Schedule H, Part V, Section B, 1f]

The CHNA analysis and report yielded a wealth of information about the health status,

behaviors and needs for our population. A distinct advantage of the primary

quantitative (survey) research is the ability to segment findings by geographic,

demographic and health characteristics to identify the primary and chronic disease

needs and other health issues of vulnerable populations, such as uninsured persons,

low-income persons, and racial/ethnic minority groups.

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For additional statistics about uninsured, low-income, and minority health needs please

refer to the complete PRC Community Health Needs Assessment report, which can be

viewed online at http://swedishcovenant.healthforecast.net.

Public Dissemination [IRS Form 990, Schedule H, Part V, Section B, 5-5c]

This Community Health Needs Assessment is available to the public using the following

URL: http://swedishcovenant.healthforecast.net. HealthForecast.net™ is an interactive,

dynamic tool designed to share CHNA data with

community partners and the public at large.

This site:

Informs readers that the CHNA Report is available and provides instructions for

downloading it;

Offers the CHNA Report document in a format that, when accessed,

downloaded, viewed, and printed in hard copy, exactly reproduces the image of

the report;

Grants access to download, view, and print the document without special

computer hardware or software required for that format (other than software

that is readily available to members of the public without payment of any fee)

and without payment of a fee to the hospital organization or facility or to

another entity maintaining the website.

Links to this dedicated HealthForecast.net™ site are also made available at SCH’s

hospital website at: www.SwedishCovenant.org.

SCH will provide any individual requesting a copy of the written report with the direct

website address, or URL, where the document can be accessed. SCH will also maintain

at its facilities a hardcopy of the CHNA report that may be viewed by any who request

it.

http://swedishcovenant.healthforecast.net/

http://swedishcovenant.healthforecast.net/

http://www.swedishcovenant.org/

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Health Needs of the Community [IRS Form 990, Schedule H, Part V, Section B, 1e]

Areas of Opportunity for Community Health Improvement

The following “health priorities” (listed in alphabetical order) represent recommended

areas of intervention, based on the information gathered through this Community

Health Needs Assessment and the guidelines set forth in Healthy People 2020. From

these data, opportunities for health improvement exist in the region with regard to the

following health areas (see also the complete Community Health Needs Assessment for

additional health indicators).

Prioritization Process [IRS Form 990, Schedule H, Part V, Section B, 1g, 6g]

After reviewing the Community Health Needs Assessment findings, the CHNA Steering

Committee Chairpersons met with Swedish Covenant Hospital’s Executive Council on

Monday, January 7, 2013 and Monday, April 15, 2013, to determine the health needs to

be prioritized for action in FY2014-FY1016.

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The group assessed key local data findings (Areas of Opportunity) and ranked identified

health issues against the following criteria:

Magnitude. The number of persons affected, also taking into account variance

from benchmark data and Healthy People targets.

Impact/Seriousness. The degree to which the issue affects or exacerbates

other quality of life and health-related issues.

Feasibility. The ability to reasonably impact the issue, given available

resources.

Consequences of Inaction. The risk of not addressing the problem at the

earliest opportunity.

Prioritization Results

Based on the hospital’s areas of expertise and partnerships with local community

organizations, the Areas of Opportunity were prioritized as follows:

1. Access to Health Services

2. Heart Disease & Stroke

3. Nutrition, Physical Activity & Weight

4. Mental Health & Mental Disorders

5. Cancer

6. Maternal, Infant & Child Health

7. Respiratory Diseases

8. Injury & Violence Prevention

9. Chronic Kidney Disease

10. Family Planning

11. Infectious Diseases

12. Sexually Transmitted Diseases

13. Substance Abuse

14. HIV

Community-Wide

Community Benefit Planning [IRS Form 990, Schedule H, Part V, Section B, 6c-6d]

As individual organizations begin to parse out the information from the 2012

Community Health Needs Assessment, it is Swedish Covenant Hospital’s hope and

intention that this will foster greater desire to embark on a community-wide

community health improvement planning process. SCH has expressed this intention to

partnering organizations and is committed to being a productive member in this

process as it evolves.

As part of our commitment to collaboration with local community organizations, SCH

engaged one class from North Park University’s Masters of Nursing program to analyze

results from the Community Health Needs Assessment and recommend best practices,

local opportunities and local potential partnerships to enhance and improve the

outcomes of the top identified health needs. These students interviewed local

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organizations, prepared projects and presented to their fellow classmates ideas

including the Centering Pregnancy model (embraced by Erie Family Health), enhanced

breast health outreach in the Polish community, outreach through faith communities,

and others. SCH will continue to explore some of these suggestions and potential

partnerships for improvements in population-based health initiatives.

Additionally, members from the focus groups, along with other local civic and ethnic

leaders, were invited to engage in ongoing conversation as part of a newly formed

Community Health Advisory Group. This group has met frequently over the past

months to discuss health care reform, funding opportunities and ways in which to

educate and inform our local communities (as part of the Access to Care priority). In the

coming months, this group will continue to engage in dialogue surrounding other area

health needs. Swedish Covenant Hospital has served as a leader during these

conversations and has also helped to identify and strengthen collaborations among

other participating organizations.

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Swedish Covenant Hospital

FY2014-FY1016 Implementation Strategy

For more than 125 years, Swedish Covenant Hospital has demonstrated its commitment to

meeting the health needs of Chicago’s north and northwest communities.

This summary outlines Swedish Covenant Hospital’s plan (Implementation Strategy) to address our community’s

health needs by 1) sustaining efforts operating within a targeted health priority area; 2) developing new programs

and initiatives to address identified health needs; and 3) promoting an understanding of these health needs among

other community organizations and within the public itself.

Hospital-Level Community Benefit Planning

Priority Health Issues To Be Addressed

In consideration of the top health priorities identified through the CHNA process —

and taking into account hospital resources and overall alignment with the hospital’s

mission, goals and strategic priorities — it was determined that Swedish Covenant

Hospital would focus on developing and/or supporting strategies and initiatives to

improve:

Access to Health Services

Heart Disease & Stroke

Nutrition, Physical Activity & Weight

Mental Health & Mental Disorders

Cancer

Maternal, Infant & Child Health

Respiratory Diseases

Integration With

Operational Planning [IRS Form 990, Schedule H, Part V, Section B, 6e]

The FY2014 Strategic Operating Plan addresses many of the major prioritizations of the

Community Benefits plan through Primary Care expansion, a Women’s Health Center,

and a Cardio-Pulmonary Center which will support addressing the above priorities.

Priority Health Issues That

Will Not Be Addressed & Why [IRS Form 990, Schedule H, Part V, Section B, 7]

In acknowledging the wide range of priority health issues that emerged from the CHNA

process, Swedish Covenant Hospital determined that it could only effectively focus on

those which it deemed most pressing, most under-addressed, and most within its ability

to influence.

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Health Priorities

Not Chosen for Action Reason

Injury & Violence

Prevention

SCH has limited resources available to address injury and violence

prevention. Other community organizations have infrastructure and

programs in place to better meet this need; however, it should be

noted that the SCH Emergency Department Chairman does

participate in the Attorney General/Community Justice Center’s gun

violence prevention outreach initiatives. Limited resources excluded

this as an area chosen for action.

Chronic Kidney Disease SCH regularly partners with organizations including the National

Kidney Foundation to provide free screenings to the ethnicities most

vulnerable to this disease. SCH feels that efforts outlined herein to

improve access to health services will also have a positive impact on

chronic kidney disease and that a separate set of specific initiatives

was not necessary.

Family Planning Advisory committee members believe that the new partnership with

Erie Family Health will not only enhance access to care but will also

positively impact outreach regarding family planning education, as

many uninsured individuals will be directed to Erie to establish a

medical home. Erie and other community organizations have

infrastructure and programs in place to better meet this need, and

as a result this was excluded as an area chosen for action.

Infectious Diseases Advisory committee members felt that more pressing health needs

existed. Limited resources and lower priority excluded this as an

area chosen for action.

Sexually Transmitted

Diseases

SCH believes that this priority area falls more within the purview of

the county health department and other community organizations.

Limited resources and lower priority excluded this as an area chosen

for action.

Substance Abuse SCH has limited resources, services and expertise available to

address alcohol, tobacco and other drug issues. Other community

organizations have infrastructure and programs in place to better

meet this need. However, the hospital is exploring the feasibility of

initiating an in-house smoking cessation program, which is

mentioned later in this document. Limited resources excluded this

as an area chosen for action.

HIV SCH believes that this priority area falls more within the purview of

the county health department and other community organizations.

Limited resources and lower priority excluded this as an area chosen

for action.

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Implementation Strategies & Action Plans [IRS Form 990, Schedule H, Part V, Section B, 6f-6h]

The following displays outline SCH’s plans to address those priority health issues chosen for action in the FY2014-

FY1016 period.

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ACCESS TO HEALTH SERVICES

Community Partners

Erie Family Health Center

Swedish Covenant Medical Group

Swedish Covenant Hospital’s Community Health Advisory Group and Elected Officials

Land of Lincoln Health

Goal

To improve healthcare access services by partnering with a Federally Qualified Health

Center on the Swedish Covenant Hospital Campus. Also, to increase enrollment in health

insurance by partnering with local ethnic and business organizations and raising

awareness about the Illinois Health Insurance Marketplace.

Outcome Measures

Number of uninsured Emergency Department patients who are subsequently transitioned to

Erie to establish a medical home and apply for Medicaid or other insurance if eligible. Number

of local community members who enroll through IL Health Insurance Marketplace and Land of

Lincoln Health to acquire health insurance (or enroll in Medicaid if eligible).

Timeframe FY2014-FY1016

Scope This strategy will focus on uninsured residents within the SCH service area.

Strategies & Objectives

Strategy #1: Identify improper utilization of the SCH Emergency Department and direct

patients to Erie for care.

Partner with Erie navigators to enroll qualified individuals in Medicaid and establish

medical home with Erie Foster Avenue Health Center.

Partner with Erie to refer Erie patients to SCMG specialists when focused, expert care is

needed.

Strategy #2: Partner with area navigators to identify and enroll eligible individuals into

Medicaid or into insurance through the Health Insurance Marketplace.

Conduct 5-10 information sessions at the hospital and in the community at civic and ethic

organizations to educate the local community about new and expanded health care

coverage options.

Assist Land of Lincoln Health in educating and enrolling local uninsured individuals and

families into health insurance packages and establishing a medical home with Swedish

Covenant Hospital.

Strategy #3: Provide transitional care coordination through Care Transitions Program.

Via the hospital’s Care Transitions Program, call recently discharged patients to assess

educational and social support needs.

Patients identified at risk for readmission will receive a home visit by a Wellness Coach

(WC). The WC performs medication reconciliation, education and assistance in scheduling

physician appointments and needed transportation.

Continue to seek grants to help support the cost of this program (currently supported by

grants from George A. Ackermann Memorial Fund and the VNA Foundation; however, the

hospital still covers approximately $60,000 annually to support the Care Program).

Strategy #4: Expand culturally sensitive care administered by the Swedish Covenant

Medical Group.

Employ physicians who speak specific languages to better meet the needs of our diverse

community. (Dr. Concepcion, Spanish-speaking cardiology; Dr. Kmiecik, Polish-speaking

PCP; Dr. Nguyen, Vietnamese-speaking PCP; Dr. Hassan, Arabic speaking OB; Dr. Chama

Matar, Arabic-speaking, female FM; Dr. Hanna Konarzewska, Polish speaking

Electrophysiology and Women’s Heart Disease).

Strategy #5: Implement Health Information Exchange and Portals for Swedish Covenant

Hospital.

Improve patient care by making the patient record more available to providers of care.

Reduce cost due to repeat testing and availability/accessibility of results.

Patient portal will allow patients to be more informed and involved in their care. They will

see results and be able to review discharge instructions, request appointments, refills and

communicate with their doctors.

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Financial Commitment

$TBD ($60,000 (Care Transitions) + Erie partnership annual costs + $15,387 Health Information

Exchange implementation first year + $35,000 annual subscription HIE (discounted to $23,507

first year) + $21,372 (annual HIE management fee)

Anticipated Outcomes

Decrease in number of uninsured patients utilizing hospital services (due to marketplace

or Erie medical home).

Strengthened partnership between Erie and Swedish Covenant Hospital – better outcomes

for patients and access to specialist referrals.

Decrease in number of readmissions due to Care Transitions support.

Better patient outcomes and enhanced transparency among providers through clinical

integration.

Results Pending

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HEART DISEASE & STROKE

Community Partners Ackermann Foundation

VNA Foundation

Goal

To provide a safe transition from hospital to home. Also, to educate the community about heart

disease and stroke risk factors by providing community education and blood pressure screening

events featuring SCH physicians and nurses.

Outcome Measures Reduce 30-day readmission rates for Heart Failure and Heart Attack.


Scope This strategy will focus on patients at-risk for readmission (regardless of insurance status) as

well as general community members within the SCH service area.


Strategy #1: Discharge Navigators play a leading role for patient follow up and support.

Discharge Navigators (DN) call cardiac patients discharged from the hospital within 24-48

hours to answer questions/concerns post hospitalization.

The DN arrange for additional support as necessary (home health, transportation,

Wellness Coaching or telemonitoring).

Strategy #2: Wellness Coach and telemonitoring helps patients at risk for re-admission.

Home visit by SCH Wellness Coach to review prescribed medications and provide disease

specific education.

90-day home telemonitoring for patients at risk for readmission.

Strategy #3: Educate community about risk factors and warning signs of heart disease

and stroke.

Collaborate with Stroke Education Coordinator to provide blood pressure screenings in

community and education related to warning signs/risk factors for heart disease and

stroke.

Collaborate with physicians to provide education to community groups.

Financial Commitment Grant funding is $130,000 per year with SCH funding approximately $60,000 annually


Reduce 30-day readmission rate.

Improve the percent of patients with a physician appointment within 7-14 days post

discharge.

Increase heart failure self-care knowledge.

Increase community awareness about risk for heart disease and stroke.

Results Pending

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NUTRITION, PHYSICAL ACTIVITY & WEIGHT

Community Partners

Whole Foods Market Sauganash

Purple Asparagus

Mariano’s Fresh Market

Budlong Elementary School

Peterson Garden Project

Goal

To educate the community and local families about healthy eating and healthy lifestyles. Also,

to participate in a community garden project to increase awareness about edible gardening and

healthy lifestyle habits.

Outcome Measures Number of people educated regarding healthy eating, fitness and nutrition.


Scope SCH service area


Strategy #1: Provide community education regarding healthy eating and fitness.

Offer a minimum of 25 programs annually focused on healthy eating, cooking, diabetes

prevention or fitness – in partnership with various local grocers and organizations.

Highlight specific cultural groups to present focused nutrition information, including

nutrition tips for the Indo American Center and Centro Romero.

Support community events related to fitness and nutrition, including the WTTW Kids Fun

and Run.

Strategy #2: Provide year-long healthy eating and lifestyle curriculum to select students

at Budlong Elementary School.

Partner with Purple Asparagus to deliver healthy eating curriculum “Delicious Nutritious

Adventures” to one grade level of students per year (consisting of one 45 min program

per month).

Partner with Budlong to provide enhancements to 7th

grade science and wellness

curriculums through guest speakers and tours of SCH and GLC.

Strategy #3: Provide 1-1 diabetes support and community education through the SCH

Diabetes Community Center.

Provide community educational sessions regarding diabetes prevention, management and

support.

Provide education through group classes as well as individual sessions to type 1, type 2,

and gestational diabetics.

Strategy #4: Explore grant funding opportunities related to nutrition and healthy lifestyle

habits.

Work with SCH Foundation to identify grants and mini-grants which support nutrition

initiatives, focusing on women, children or specific cultural groups within the community.

Financial Commitment $ 15,000


Provide healthy eating curriculum to more than 250 students.

Lower A1C levels in 75% of patients visiting Diabetes Community Center.

Provide outreach and support regarding healthy eating, nutrition and fitness to more than

5,000 local community members annually.

Results Pending

19

MENTAL HEALTH & MENTAL DISORDERS

Community Partners

North River Expanded Mental Health Services Program and Governing Commission

Local elected officials

Erie Family Health

Lutheran Social Services (Project IMPACT)

Goal

To expand and extend mental health services to mentally ill residents who need the assistance

of their communities in overcoming or coping with mental or emotional disorders, with a

special focus on early intervention and prevention of such disorders.

Outcome Measures

Reduction of improper usage of our Emergency Department for individuals with mental illness

who are best suited for care in an outpatient setting. Reduction in ED recidivism for individuals

with mental illness. Increase of funding for local mental health providers and social service

agencies to provide care for mentally ill community members.




Strategy #1: Serve on the North River Expanded Mental Health Services Program

Governing Commission.

Mary Shehan, Chief Nursing Officer, was appointed by Mayor Rahm Emanuel to serve as

one of nine appointed commissioners overseeing the program.

Strategy #2: Decrease improper usage of the Emergency Department for mentally ill

cases.

To increase the number of mentally ill individuals being well cared for in a community

setting, ultimately decreasing improper use of Emergency Department services. If and

when individuals do seek care, additional resources in the community will assist SCH in

providing community referrals for outpatient care.

To maintain and enhance partnership with Lutheran Social Services Project IMPACT and

the care they provide through the hospital’s ED.

Strategy #3: Dialogue with area legislators regarding the desperate need for mental

health services and funds allocation.

Meet with area legislators about lack of outpatient mental health services on Chicago’s

north side.

Financial Commitment $5,000 in kind donation of time


Expansion of outpatient mental health services for uninsured and Medicaid patients.

Reduction in number of individuals with mental illness who present to the ED for non-

medical concerns.

Reduction in ED recidivism for individuals with mental illness.

Results Pending

20

CANCER

Community Partners

Rush University Medical Center

CyberKnife Cancer Institute of Chicago

American Cancer Society

Susan G. Komen Foundation

National Breast Cancer Foundation

Goal

To increase the community’s access to additional research studies and advanced surgical

procedures by Rush surgeons; to increase the community’s access to pain-free, noninvasive

treatments for complex tumors while sparing healthy tissue; to provide breast cancer screening,

diagnosis and navigation to uninsured and underinsured women in our community through the

Susan G. Komen Foundation and other breast health grants; to provide additional cancer

screenings throughout the SCH service area, including ethnic organizations such as the Polish

National Alliance.

Outcome Measures

Number of uninsured and low-income women navigated through breast care continuum.

Number of uninsured and low-income women who receive breast cancer screening. Number of

patients who gain access to Rush specialists or clinical trials. Number of patients who benefit

from noninvasive CyberKnife treatment.




Strategy #1: Increase local community’s access to cancer screening, treatment and care,

regardless of income level or insurance status.

Continue affiliation with Rush ($29K) to increase local community’s access to specialized

treatment and care.

Employment of 5 oncologists through the Swedish Covenant Medical Group allows SCH to

ensure a continuum of care and quality treatment for patients, regardless of insurance

status.

Provide pain-free, noninvasive treatment for complex tumors to all medically qualified

individuals regardless of their insurance status through the CyberKnife Cancer Institute of

Chicago (CCIC), the only CyberKnife facility in Chicago.

Advocate for approval of CyberKnife to treat prostate cancer patients in Illinois (Dr. Adam

Dickler, Medical Director of CCIC serves as a leader, meeting with the Medical Director of

Blue Cross Blue Shield of IL to share 5 year data statistics and other supporting evidence –

treatment is already approved in other states).

Apply for grant funding related to patient care enhancements, including application to

federally-funded PCORI study (Patient Centered Outcomes Research Institute) – focused

on patient outcome improvements through non-reimbursed care including nutrition

education, physical therapy, alternative medicine, massage and health psychology

integration. These treatments are provided concurrently with traditional therapies such as

chemotherapy, radiation and surgery. If awarded SCH will cover approximately $55,000 in

in-kind staff time.

Strategy #2: Serve the uninsured and underinsured in our local service area by providing

free and reduced cost mammograms and breast cancer treatment through charity care as

well as grant opportunities.

Partner with National Breast Cancer Foundation to provide screening mammograms to at

least 300 women annually.

Partner with Susan G. Komen Foundation to provide biopsies and funding toward nurse

navigation.

Continue to research, identify and submit applications to further enhance our care and

outreach within the local community.

21

Strategy #3: Provide cancer screenings and cancer prevention educational seminars and

smoking cessation initiatives throughout the community.

Provide 3-5 annual cancer screenings including: prostate, skin and cervical.

Provide at least 15 programs annually related to cancer prevention, healthy nutrition

habits, fitness and other healthy lifestyle recommendations.

Explore feasibility of in-house interdisciplinary smoking cessation program.

Financial Commitment $ 61,000 (29,000 (Rush annual fee) + $32,000 (annual navigator approximation for uninsured

care delivery) Note: + $55,000 if funded by PCORI grant

Anticipated Outcomes Increase access to Rush clinical trials, with special focus on low volume cases.

Broader expert panel for case review with Virtual Rush/SCH tumor boards.

Results Pending

22

MATERNAL, INFANT & CHILD HEALTH

Community Partners

Baby-Friendly USA

CLOCC

CEDA-WIC

Chicago Coalition for Breastfeeding

Erie Family Health

March of Dimes/VHA

Goal

To become accredited as one of the first Baby-Friendly hospitals in Chicago. To partner with

Erie and CEDA-WIC to explore the creation of an outpatient lactation clinic, potentially housed

within Erie Foster Avenue Medical Center.

Outcome Measures

Improve the breastfeeding rates of women delivering at the hospital and rates of breastfeeding

throughout the first year of life. Decrease rate of elective inductions prior to 39 weeks

gestational age.


Scope SCH service area, with special focus on the local uninsured and Medicaid population


Strategy #1: Become accredited as a Baby-Friendly hospital and explore creation of an

outpatient breastfeeding clinic.

Complete dissemination phase, including educational requirements for staff and

physicians.

Educate community about our commitment as a Baby Friendly hospital and the benefits.

Apply for funding to support creation of an outpatient breastfeeding clinic on the campus

of Swedish Covenant Hospital.

Strategy #2: Enhance partnership with March of Dimes and VHA on 39 week initiative.

Partner with local ethnic groups to educate regarding the importance of minimizing non-

elective induced births at less than 39 weeks gestation.

Continue to educate physicians and the community regarding the importance of baby

development during final weeks of pregnancy to minimize early elective births.

Strategy #3: Consider applying for Level II NICU status.

Evaluate the benefit for patients if SCH achieved Level II NICU status.

Reduce transfers to other hospitals if NICU status changed.

Financial Commitment

$ 21,235 ($17,235 Baby Friendly Staff Educational Costs Year One + $1,000 Baby Friendly

Development Phase +$3,000 Baby Friendly Dissemination Phase + TBD NICU Level II

Exploration costs)

Anticipated Outcomes Swedish Covenant Hospital will be designated as a Baby Friendly Hospital.

Swedish Covenant Hospital will partner on an outpatient breastfeeding clinic.

Results Pending

23

RESPIRATORY DISEASES

Community Partners Local chambers of commerce

Local ethnic organizations

Goal

To promote the importance of annual flu shots and provide SCH pharmacists as a resource for

businesses and ethnic groups to offer group flu shot events throughout the community at a

discounted cost. Also, to increase offerings for respiratory screenings and treatments within the

new cardiology center.

Outcome Measures

Improve the identification of patients that are eligible and would benefit from Pulmonary

Rehabilitation. Rehab is presently offered in the Galter Life Center and is one of the only

Pulmonary Rehab programs in the Chicagoland area certified for many years through the

American Association of Cardiovascular and Pulmonary Rehabilitation.




Strategy #1: To enhance pulmonary services, as part of the GMP 4 Renovation (Women’s

Health Center and Cardiology suites) and work towards certification as a Pulmonary

Center of Excellence.

Expand our existing ability to provide Pulmonary Function Testing.

Add new services including Pulmonary Stress Testing using a metabolic cart.

Utilize a body box, which will enable physicians to detect certain pulmonary conditions

that conventional pulmonary function testing cannot.

Strategy #2: To develop and enhance the Pulmonary Fellowship program at SCH.

Provide fellows with a more thorough experience and education due to enhanced

diagnostic tools (pulmonary function testing, body box) and respiratory screenings.

Strategy #3: To educate local businesses about importance of annual flu shots.

Increase awareness through online and print channels about the importance of annual flu

shots.

Promote availability of SCH pharmacists to provide flu shots for area business employees

at a discounted price.

Financial Commitment $ 100,000 (expansion of services and new testing offerings in Women’s Health Center and

Cardiology)

Anticipated Outcomes Identify additional eligible patients who would benefit from Pulmonary Rehabilitation.

Provide flu shots to interested local business owners and general community members.

Results Pending

24

Adoption of Implementation Strategy [IRS Form 990, Schedule H, Part V, Section B, 6a-6b]

On September 18, 2013, the Board of Swedish Covenant Hospital, which includes

representatives from throughout Chicagoland, met to discuss this plan for addressing the

community health priorities identified through our Community Health Needs Assessment.

Upon review, the Board approved this Implementation Strategy and the related budget items to

undertake these measures to meet the health needs of the community.

SCH Board Approval & Adoption:

Lawrence P. Anderson, Asst. Secretary

By Name & Title

9-18-13

Date

Swedish Covenant Hospital

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